Enhancing Collaborative Learning for Quality Improvement: Evidence from the Improving Clinical Flow Project, a Breakthrough Series Collaborative with Project ECHO

BackgroundImprovement work can be used in preschools to enrich outdoor environment for children’s better health. Effective improvement work can facilitate the necessary changes, but little is known about professionals’ experiences of participation in improvement interventions. The aim was to evaluate how preschool staff experience quality improvement work, using the Breakthrough Series Collaborative improvement programme, to enhance outdoor environments.MethodsAn improvement intervention using a breakthrough collaborative was performed at 9 preschools in Sweden and examined with a longitudinal mixed method design. Staff completed questionnaires on 4 occasions (n=45 participants) and interviews took place after the intervention (n=16 participants).ResultsThe intervention was successful in the sense that the staff were content with the learning seminars, and they had triggered physical changes in the outdoor environment. They integrated the quality improvement work with their ordinary work and increasingly involved the children. The staff tested improvement tools but did not find them entirely appropriate for their work, because they preferred existing methods for reflection.ConclusionsThe challenges in quality improvement work seem to be similar across contexts. Using the Breakthrough Series Collaborative in a public health intervention is promising but needs to be integrated with preunderstandings, current reflections and quality tools and models.

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Using Breakthrough Series Collaborative Methodology to Improve Safe Delivery of Chemotherapy in Ontario

Journal of Oncology Practice ◽

10.1200/jop.2013.001254 ◽

2014 ◽

Vol 10 (4) ◽

pp. e240-e246 ◽

Cited By ~ 3

Author(s):

Vicky Simanovski ◽

Esther Green ◽

Elaine Meertens ◽

Leonard Kaizer ◽

Noor Ahmad ◽

...

Keyword(s):

Quality Improvement ◽

Knowledge Translation ◽

Interdisciplinary Teams ◽

Safe Delivery ◽

Overall Evaluation ◽

Knowledge Translation And Exchange ◽

Breakthrough Series Collaborative ◽

Collaborative Methodology ◽

Breakthrough Series

Participation in a collaborative enabled local interdisciplinary teams to develop processes and structures to support ongoing quality improvement, including formation of a sustainable structure for knowledge translation and exchange, but lack of a shared provincial target limited overall evaluation.

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The Maryland Resilience Breakthrough Series Collaborative: A Quality Improvement Initiative for Children’s Mental Health Services Providers

Psychiatric Services ◽

10.1176/appi.ps.201500036 ◽

2015 ◽

Vol 66 (8) ◽

pp. 778-780 ◽

Cited By ~ 1

Author(s):

Penina M. Backer ◽

Laurel J. Kiser ◽

Jane E. Gillham ◽

Joan Smith

Keyword(s):

Mental Health ◽

Quality Improvement ◽

Mental Health Services ◽

Health Services ◽

Children’S Mental Health ◽

Children's Mental Health ◽

Quality Improvement Initiative ◽

Children’S Mental Health Services ◽

Breakthrough Series Collaborative ◽

Breakthrough Series

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Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting

BMC Health Services Research ◽

10.1186/s12913-019-4472-8 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Laura Beamish ◽

Zach Sagorin ◽

Cole Stanley ◽

Krista English ◽

Rana Garelnabi ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Opioid Use ◽

Agonist Therapy ◽

Opioid Agonist ◽

Opioid Agonist Therapy ◽

Care Processes ◽

Breakthrough Series Collaborative ◽

Collaborative Methodology ◽

Breakthrough Series

Abstract Background Although opioid agonist therapy is effective in treating opioid use disorders (OUD), retention in opioid agonist therapy is suboptimal, in part, due to quality of care issues. Therefore, we sought to describe the planning and implementation of a quality improvement initiative aimed at closing gaps in care for people living with OUD through changes to workflow and care processes in Vancouver, Canada. Methods The Best-practice in Oral Opioid agoniSt Therapy (BOOST) Collaborative followed the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology over 18-months. Teams participated in a series of activities and events to support implementing, measuring, and sharing best practices in OAT and OUD care. Teams were assigned monthly implementation scores to monitor their progress on meeting Collaborative aims and implementing changes. Results Seventeen health care teams from a range of health care practices caring for a total of 4301 patients with a documented diagnosis of OUD, or suspected OUD based on electronic medical record chart data participated in the Collaborative. Teams followed the Breakthrough Series Collaborative methodology closely and reported monthly on a series of standardized process and outcome indicators. The majority of (59%) teams showed some improvement throughout the Collaborative as indicated by implementation scores. Conclusions Descriptive data from the evaluation of this initiative illustrates its success. It provides further evidence to support the implementation of quality improvement interventions to close gaps in OUD care processes and treatment outcomes for people living with OUD. This system-level approach has been spread across British Columbia and could be used by other jurisdictions facing similar overdose crises.

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A Collaborative Model for Facilitating the Delivery of Smoking Cessation Treatments to Cancer Patients: Results From Three Oncology Practices in South Carolina

The Journal of Smoking Cessation ◽

10.1017/jsc.2018.23 ◽

2018 ◽

Vol 14 (2) ◽

pp. 112-124

Author(s):

Daniel J. Kilpatrick ◽

Kathleen B. Cartmell ◽

Abdoulaye Diedhiou ◽

K. Michael Cummings ◽

Graham W. Warren ◽

...

Keyword(s):

Smoking Cessation ◽

South Carolina ◽

Quality Improvement ◽

Collaborative Learning ◽

Cancer Patients ◽

Tobacco Use ◽

Tobacco Cessation ◽

Dissemination And Implementation ◽

Evidence Based ◽

Cancer Centers

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.

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